A narrative review of Master’s programs in midwifery across selected OECD countries: Organizational aspects, competence goals and learning outcomes

Shifting midwifery education to a university level is of great importance for healthcare systems worldwide by preparing graduates for current and future challenges. Some of them referring to management, research and teaching tasks as well as advanced practitioner roles, require competences that can only be acquired in a Master's program. The objectives of this narrative review are to outline the differences and commonalities of organizational aspects of Master’s programs in selected OECD countries and to point out the competence goals and learning outcomes they are based on. Fifteen Master’s programs in twelve OECD countries were identified and analyzed. Considering the organizational characteristics, differences are found in admission requirements and qualification levels, while similarities relate to the awarded title (MSc). All programs aim to develop abilities for research to advance midwifery practice. Leadership and management abilities are addressed through effective teamwork and communication. The programs’ aims are to develop abilities for midwifery education tasks. Whereas competence goals mostly align across the programs, they are addressed differently through various learning outcomes. Development and enhancement of Master’s programs in midwifery are needed by focusing on core elements, such as common competence goals. It is equally important to adapt them to national healthcare and educational systems.

Selection process 8 Specify the methods used to decide whether a study met the inclusion criteria of the review, including how many reviewers screened each record and each report retrieved, whether they worked independently, and if applicable, details of automation tools used in the process.

Data collection process
9 Specify the methods used to collect data from reports, including how many reviewers collected data from each report, whether they worked independently, any processes for obtaining or confirming data from study investigators, and if applicable, details of automation tools used in the process.

p. 3-5
Data items 10a List and define all outcomes for which data were sought.Specify whether all results that were compatible with each outcome domain in each study were sought (e.g. for all measures, time points, analyses), and if not, the methods used to decide which results to collect.
p. 3-5 10b List and define all other variables for which data were sought (e.g.participant and intervention characteristics, funding sources).Describe any assumptions made about any missing or unclear information. n.a.

Study risk of bias assessment
11 Specify the methods used to assess risk of bias in the included studies, including details of the tool(s) used, how many reviewers assessed each study and whether they worked independently, and if applicable, details of automation tools used in the process.

p. 3-5
Effect measures 12 Specify for each outcome the effect measure(s) (e.g.risk ratio, mean difference) used in the synthesis or presentation of results.n.a.

Synthesis methods
13a Describe the processes used to decide which studies were eligible for each synthesis (e.g.tabulating the study intervention characteristics and comparing against the planned groups for each synthesis (item #5)).
p. 3-5 13b Describe any methods required to prepare the data for presentation or synthesis, such as handling of missing summary statistics, or data conversions. n.a.
13c Describe any methods used to tabulate or visually display results of individual studies and syntheses.n.a.
13d Describe any methods used to synthesize results and provide a rationale for the choice(s).If meta-analysis was performed, describe the model(s), method(s) to identify the presence and extent of statistical heterogeneity, and software package(s) used.
p. 3-5 13e Describe any methods used to explore possible causes of heterogeneity among study results (e.g.subgroup analysis, meta-regression).n.a.

Item # Checklist item
Location where item is reported 13f Describe any sensitivity analyses conducted to assess robustness of the synthesized results. n.a.

Reporting bias assessment
14 Describe any methods used to assess risk of bias due to missing results in a synthesis (arising from reporting biases).n.a.

Certainty assessment
15 Describe any methods used to assess certainty (or confidence) in the body of evidence for an outcome.n.a.

Study selection 16a
Describe the results of the search and selection process, from the number of records identified in the search to the number of studies included in the review, ideally using a flow diagram.

Results of individual studies
19 For all outcomes, present, for each study: (a) summary statistics for each group (where appropriate) and (b) an effect estimate and its precision (e.g.confidence/credible interval), ideally using structured tables or plots. n.a.

Results of syntheses 20a
For each synthesis, briefly summarise the characteristics and risk of bias among contributing studies.n.a.
20b Present results of all statistical syntheses conducted.If meta-analysis was done, present for each the summary estimate and its precision (e.g.confidence/credible interval) and measures of statistical heterogeneity.If comparing groups, describe the direction of the effect. n.a.
20c Present results of all investigations of possible causes of heterogeneity among study results.n.a.
20d Present results of all sensitivity analyses conducted to assess the robustness of the synthesized results.n.a.
Reporting biases 21 Present assessments of risk of bias due to missing results (arising from reporting biases) for each synthesis assessed.n.a.

Certainty of evidence
22 Present assessments of certainty (or confidence) in the body of evidence for each outcome assessed.n.a.

Fig. 1
Fig. 1 SANRA -Scale Specify all databases, registers, websites, organisations, reference lists and other sources searched or consulted to identify studies.Specify the date when each source was last searched or consulted.
, Prisma Flowchart16b Cite studies that might appear to meet the inclusion criteria, but which were excluded, and explain why they were excluded.

Literature search strings for the narrative reviews used in various databases
Filter "published 2000 onwards" and languages English and German activated in each search string

Table 1 :
PubMed Search Strings

Table 2 :
ScienceDirect Search Strings

Table 3 :
Educational Resources Information Center (ERIC)

Table 4 :
Academic Search Premier

Table 5 :
Wiley Online Library